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Updated: Sep 14, 2025

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
19:57

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

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HIV-1 Drug Resistance in Children and Implications for Pediatric Treatment Strategies: A Systematic Review and

Joseph Fokam1,2,3,4, Aude Christelle Ka'e1, Bouba Yagai1,5

  • 1Laboratory of Virology, Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.

Open Forum Infectious Diseases
|July 23, 2025
PubMed

Insights

High rates of pretreatment and acquired drug resistance in children with HIV (CWHIV) necessitate phasing out NNRTIs. Emerging INSTI resistance underscores the need for robust drug resistance surveillance in CWHIV.

Area of Science:

  • Virology
  • Infectious Diseases
  • Public Health

Background:

  • Prevention of mother-to-child HIV transmission (PMTCT) failures and treatment challenges contribute to drug resistance in children with HIV (CWHIV).
  • Pretreatment drug resistance (PDR) and acquired drug resistance (ADR) pose significant threats to effective HIV management in pediatric populations.
  • Understanding the landscape of drug resistance is crucial for optimizing treatment strategies and improving outcomes for CWHIV.

Purpose of the Study:

  • To determine the prevalence of PDR and ADR in children with HIV (CWHIV).
  • To identify key drug resistance mutations driving PDR and ADR in CWHIV.
  • To inform strategies for managing HIV drug resistance in pediatric populations.

Main Methods:

  • A systematic review and meta-analysis of interventional and observational studies published between 2010 and 2024.
  • Inclusion of data on PDR and ADR in CWHIV, analyzed using random effects models.
  • Synthesis of findings from 72 studies encompassing 9973 children.

Main Results:

  • The overall prevalence of PDR was 32.48% and ADR was 61.43% in CWHIV.
  • PDR was significantly higher in children who failed PMTCT prophylaxis (43.23%).
  • Nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations were the primary drivers of both PDR (28.38%) and ADR (65.17%); emerging integrase strand transfer inhibitor (INSTI) resistance was observed (5.53%).

Conclusions:

  • High burdens of PDR and ADR exist among CWHIV, indicating a need to phase out pediatric NNRTIs for PMTCT and treatment.
  • Emerging INSTI resistance in CWHIV highlights the critical importance of ongoing drug resistance surveillance.
  • Optimized treatment guidelines and resistance monitoring are essential for improving long-term outcomes in children living with HIV.
Abstract

Keywords:
ARTchildrensystematic review“acquired drug resistance”“pretreatment drug resistance”

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